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PHONE hJJ. = 209 369 4228 _ Feb. 09 2000 09:03AM_1`2 <br /> SAN,—jAQUIN COUNTYPUBUC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 FAST WEBER AVENUE.THIRD FLOOR <br /> STOC"CN CA M02 <br /> (203)468.3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> AV:LICANT i <br /> � //77 aEUMMIAGE NY <br /> E <br /> ADMMSS� �.a.t,.._ i <br /> � u�ur�u �r� � r3 v-�p ( .♦�� �^ <br /> FACNMMX q- 2 <br /> TENTATIVE'APPOINTMENT DATE <br /> IPlwx.plw r to to 4uunead Aa s Ira,Pi10of a Yale <br /> Pplrtaeaa aulrmlUal) O <br /> CHECK 80X TO EXPaDRt!REQUEST-Si3.0a FPE_REWEST PROCESSFA IN 3 BMIMFSa DAYS O <br /> SIGNATURE OF APPLICANT l <br /> DATE <br /> �J <br /> I Op 5,CIJA-�LASL <br /> 4 Op <br /> r <br /> 481 Lt�rgf <br /> "0LTJM)3f2 L40 ,41. <br /> V <br /> P <br /> JO CAAA-F� <br /> ��,L7, <br /> ENVIRONMENTAL HEALTH DIVISION FILES II EYED <br /> *UNCEROabUNb TANK(UST)CLEANUP SITE tLCP) C3 HOU5INC ABATEMENT 0 SOLI)WASTE FACIUrT EYED <br /> 0 OTHER CLEANUP&M-tNON-LOP) C POOP FACILITY 0 WLW%V"m VEHICLE FEB 10 2000 <br /> UND6RCROUHp TANK[ ITORMO(RWOVA4 ❑ MG KENNEL t3 LLURY <br /> PT.nALARbQ W VfASTa Gt9iERA'tOR O CHEXEN RANCH 13 PILO YREATMMT PLANT <br /> C WT0 5000 PaMICJL'Y O MOTE MUM 0 PUMPER TRUMOVAawmEm TOa.E.TS <br /> ❑ VLOCA'000YP61tCWO O POOLWA O LAm use APPUCATAN srMS <br /> 0 aEO1ClLLwA9Tf PACiLITY 3 PURUC WAYER NYSTEM ❑ OTWR(PLFAAe SPECSFY AUOV2} <br /> 1_ List up to tan addreessa in the space above. Saisct the type(s)of fUes Tram the list above by chocking <br /> the appropriata box(es). At least Ona file type MUSTbe selected_ FII10a(208)464-0138 orwafl 10the <br /> etl Laintyatrd abgyg- <br /> 2. SMD will notify the apPliuertt It any EHD files axist. An appointment for review wUl be corl(imted <br /> I1PPn3tlmateiy five business days but no Fater than ten(10)days after receipt of application_ rhe fEls: <br /> will be hold for a maximum of f ve bus'irtess days for review. Appoint rocci should be ache_ The <br /> aecordingiy. <br /> uled <br /> 3. A file that is actively being worked on by EHD staff may not be immediately avaaahle for review. A new <br /> 0. aPpikation may be submitted when the file Is available. <br /> Any Mft not returned In the Came condition as released will be reodganUmn by EHO staff at the expense <br /> of 1118 ePPlieant. Future flie reviews by the same applicant may require a$78.00 depoak prior to review. <br /> 5. 'TENTATIVE appoint nent dates must be conflmte d with END stall. <br /> G. Applications reeehed atter 3:00 Pm will be processed the nett business day_ k <br /> CONFIRMED APPOINTMENT DATE TIME } <br /> OATt:CONFIRMED PHONE FAX INITIALS <br /> I i <br /> REVILYMO YES NO REVIEW DATE j <br /> Y <br /> TOTAL P.01 <br />